Rheumatic Fever

Rheumatic Fever

What is rheumatic fever?

Rheumatic fever is a complex disease that affects the joints, skin, heart, blood vessels, and brain. It occurs mainly in children between the ages of 5 to 15. It is an immune disease that may occur after an infection with strep (streptococcus) bacteria. Strep infections include strep throat and scarlet fever. Rheumatic fever happens more often in the winter and spring. This is because strep throat infections occur more often in these seasons. Strep is contagious. This means it can be spread from person to person. But rheumatic fever is not contagious.

What causes rheumatic fever?

Rheumatic fever is an autoimmune reaction to the strep bacteria. An immune reaction is when the body attacks its own tissues. It can be prevented if strep throat is diagnosed right away and treated with antibiotics. Rheumatic fever is not common in the U.S.

Who is at risk for rheumatic fever?

Children ages 5 to 15 are most at risk for having rheumatic fever. They are most at risk if they:

Have strep throat infections often

Have strep infections that were untreated or not treated enough

Have a family history of rheumatic fever

What are the symptoms of rheumatic fever?

The symptoms usually start about 1 to 5 weeks after a child has been infected with strep bacteria. Each child’s symptoms may vary. Common symptoms can include:

Inflammation in joints such as the knees or ankles that causes swelling, soreness, and redness

Small, painless, hard bumps (nodules) under the skin, often over bony areas

Unusual jerky movements, most often of the face and hands. This is often noted by a change in a child's handwriting.

Red rash with odd edges on the torso, arms, or legs

Fever

Weight loss

Lack of energy (fatigue)

Stomach pains

These symptoms can seem like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is rheumatic fever diagnosed?

Your child’s healthcare provider will take your child’s medical history and do a physical exam. Your child may also have tests such as:

Blood tests. These are done to look for signs of inflammation, recent strep infection, and other related problems.

Electrocardiogram (ECG). This is a test that records the electrical activity of the heart. It shows abnormal rhythms and detects heart muscle damage.

Throat culture. A swab is wiped on the throat. This is done to look for the strep bacteria.

Your child's healthcare provider will look for:

Inflammation of the heart

Inflammation of more than 1 joint

Unusual jerky movements

Small, hard bumps under the skin

Red, irregular rash

Fever

Pain in 1 or more joints

Previous inflammation of the heart

Changes in the ECG pattern

Abnormal sedimentation rate or C-reactive protein in blood tests

How is rheumatic fever treated?

Children with rheumatic fever are often treated in the hospital. Your child's healthcare provider will figure out the best treatment plan for your child based on:

How old your child is

Your child’s overall health and medical history

How sick your child is

How well your child handles certain medicines, treatments, or therapies

If your child’s condition is expected to get worse

The opinion of the healthcare providers involved in your child's care

Your opinion and preference

Treatment for rheumatic fever often combines the following 3 things:

Treatment for strep. The first step is to treat the strep infection with antibiotics. This is done even if a throat culture is negative. Your child may need to take monthly doses of antibiotics. This is to help prevent other problems.

Anti-inflammatory medicines. Your child may take medicines to help decrease the swelling that occurs in the heart muscle. These medicines also help ease joint pain.

Bed rest. The length of bed rest will depend on how severe your child's illness is. Bed rest may range from 2 to 12 weeks.

Talk with your child’s healthcare provider about the risks, benefits, and possible side effects of all medicines.

What are the complications of rheumatic fever?

If the illness severely attacks a child's heart, this may damage heart valves and cause heart disease. In this case, your child may not be allowed to do some kinds of physical activity and sports.

If the heart was damaged by the fever, your child will need to take special care when going to the dentist in the future. He or she may need to take antibiotics before having dental work done. This helps lower the chance of an infection traveling to the heart during a dental procedure. Talk with your child's healthcare provider for more information.

Can rheumatic fever be prevented?

Many cases of rheumatic fever may be prevented by quickly treating strep throat with antibiotics.

Helping your child live with rheumatic fever

Having rheumatic fever increases your child's chances of having the disease again. This is at highest risk during the first 3 years. The chance of having the disease again lessens with age and time.

After having rheumatic fever, your child will need to take antibiotics every month. These are to help lessen the chance of having rheumatic fever again. Often by the time a child is 18, the antibiotic therapy may be stopped. Close follow-up with your child's healthcare provider is needed.

When should I call my child's healthcare provider?

Call the healthcare provider if your child's symptoms get worse or there are new symptoms.

Key points about rheumatic fever

Rheumatic fever is a complex disease that affects the joints, skin, heart, blood vessels, and brain.

It may occur after an infection with strep bacteria, such as strep throat or scarlet fever.

Symptoms may include joint inflammation, small hard bumps under the skin, jerky movements, a rash, and fever.

Disclaimer:This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.